It is discovered that the true meaning of Fibromyalgia is not as simple as is usually believed, but for proper elucidation requires the combined efforts of academicians of varying critical persuasions.

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Extra Sensitive “Pain/Emotion” Perception

Nancy Ryan sent in this post. It has a number of threads to it. I picked the first idea as the title. These are things I haven’t thought about much previously, and I found that the citations were interesting and enlightening.

She writes:

Maybe FM should be renamed “ESPP” for “Extra Sensitive “Pain/Emotion” Perception,” and treated more like a personality trait that requires adaptation to adjust to. I agree with the “spectrum” hypothesis. If the spectrum has fibromyalgianess as points on the scale, persons categorized on the autistic or aspergian scale would be on the opposite side of the spectrum from fibromyalgia. Indifference to pain, empathy, lack of social intuition vs over-sensitive to the emotional valence of pain, empathic responses and sensitivity to social rejection.

(And curiously, it seem to me that people I have met who study pain disorders seem to fall on this opposite end of the spectrum, perhaps from an inherent curiosity of the phenomenon they can’t relate to).

“The lessons we have learned about biodiversity and cultural and racial diversity need to be applied to the human brain. We need a new field of neurodiversity that regards human brains as the biological entities they are, and appreciates the vast natural differences that exist from one brain to another regarding sociability, learning, attention, mood and other important mental functions.

Instead of pretending that hidden away in a vault somewhere is a perfectly “normal” brain, to which all other brains must be compared (e.g., the rose psychiatrist’s brain), we need to admit that there is no standard brain, just as there is no standard flower, or standard cultural or racial group, and that, in fact, diversity among brains is just as wonderfully enriching as biodiversity and the diversity among cultures and races.”

And this one from Neuroscience. 2010 May 5. (I love the idea that the brain is collecting “memory of the future” to be prepared.)

“The sensitive type, always a minority, chooses to observe longer before acting, as if doing their exploring with their brains rather than their limbs. The other type “boldly goes where no one has gone before.” The sensitive’s strategy, sometimes called reactive or responsive, is better when danger is present, opportunities are similar and hard to choose between, or a clever approach is needed. It is not an advantage when resources are plentiful or quick, aggressive action is required. “

“The Stony Brook team proposed that differences in neuroticism and introversion are often due to something more fundamental, i.e. differences in the attention given to the processing of sensory information. For example, a number of researchers are finding that children who are highly sensitive and raised in a stressful environment are prone to anxiety and depression, which are the components of neuroticism, and to shyness, which is sometimes the cause of introversion.”

“However, when raised in an enriched, supportive environment, those with this “differential susceptibility” are actually happier, healthier, and more socially skilled than others. In both outcomes, it seems that sensitive children are paying more attention to subtle cues indicating, for better or worse, what others are thinking and feeling.”

And lastly, to the point of what “pain” is or isn’t and how it might manifest along a spectrum: “Feeling Pain, Being in Pain.” This fascinating book details the very curious disorders that involve feeling “pain” as a sensation, and identifying it as painful, but having no negative emotional valence. I think these disorders have much to teach us about the biased conceptions about the phenomenology of pain.

A review can be found here: http://ndpr.nd.edu/news/23288-feeling-pain-and-being-in-pain/

Chomsky was right – language is a key to being human. (“When we study human language, we are approaching what some might call the ‘human essence’, the distinctive qualities of mind that are, so far as we know, unique to man.”)

Pain is a complex product of language or its own language really – it just communicates information. It is clear from all the discussion here, the language has not be decoded.

3 Comments

Nancy, I hope are you not revisiting the old (and discredited) idea of a “pain prone personality”. As for the language issue, the lived experience that we call “pain” appears to be rooted in the deep structure of our language, which does not require formal decoding. We encounter an aporia if we try to do so.

Dear John, My word choice “personality trait” in my email to Dr. Wolfe, in hindsight, may not have been the most appropriate for my thoughts – what I meant is that unlike a disease of the traditional definition (infections, cancer), the symptoms we are describing as fibromylagia represent a “way of being/perception” that deviates along a continuum from the generally and socially accepted “norm” of health. Perhaps “it” is a sort of “super power” of perception gone haywire due to overloading the system (Stress? Perhaps.)

My thinking of fibromyalgia as a spectrum disorder was spurred by the “Intense World Theory” of autism (Makram and Makram, 2010). If this theory might help frame the “hyper-perception, hyper-attention, hyper-memory” in autism, a similar model might be proposed to frame the search for pathogenesis and etiology of symptoms from a “neurobiological perspective where we attempt to reconstruct the disorder from fundamental molecular, cellular, and circuit changes.”

But then again, if it were as easy as enumerating neurobiological probable cause, there would be little need for the debate.

There is a lot of work to be done to find a way out of the circular reasoning to determine “what came first”, or if there is any “first” to find (the continuum could be an infinity circle). Collecting an ever increasing assortment of symptoms (in lieu of elusive evidence of neuro-physiological mechanisms for symptoms) has certainly made for a big mess of trying to make sense of the monster.

Regarding “the lived experience that we call “pain” appears to be rooted in the deep structure of our language, which does not require formal decoding.” Agreed! It is like trying to grab hold of a cloud. It is a false dichotomy of “real pain” vs. “pain without a cause” that drives the “is or isn’t” social significance of the experience (both in relation to others and the self.)

Dear Nancy, I would not pretend to understand the ‘Intense World Theory of Autism”. However, I agree with you ‘that there is a lot of work to be done to find a way out of the circular reasoning to determine “what came first”, or if there is any “first” to find (the continuum could be an infinity circle). Collecting an ever increasing assortment of symptoms (in lieu of elusive evidence of neuro-physiological mechanisms for symptoms) has certainly made for a big mess of trying to make sense of the monster.’

When we are attempting to understand complex dynamic systems, our conventional linear model of cause and effect is not only unhelpful, but also may be irrelevant. What if “cause” and”effect” turn out to be indistinguishable?